Alaska Division of Corporations, Business, and Professional Licensing

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License Applications

Application for Licensure as a Marital and Family Therapist,
#08-4203, Revised 04/10/13.
Application for licensure by credentials or examination.
Includes application for temporary license.

Application for Approved Marital and Family Therapy Supervisor, #08-4252, Revised 04/10/13.

Application for Marital and Family Associate License,
#08-4378, Revised 04/10/13.

Biennial Marital and Family Therapy License Renewal Application, #08-4115, Revised 04/10/13.

Continuing Education Providers Approval Form,
#08-4087, Revised 04/10/13.

Miscellaneous Forms

Change of Name Form
#08-1431, Rev. 04/20/09

Change of Address Form
#08-4291, Rev. 04/20/09

Request for License Verification Form
#08-4222, Rev. 11/28/07

Request Duplicate License Form
#08-0014, Rev. 06/11/07

Credit Card Payment Form
#08-4438, Rev. 09/14/10

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Applications may be viewed and printed with Adobe Acrobat Reader 6.0 or higher. If you do not have Adobe Acrobat Reader 6.0 or higher, please click on the Adobe logo and download the free software now. If you are unable to view or download an application, please contact us by telephone or e-mail. Providing your complete mailing address will enable us to mail you the application.

Other application forms may be mailed to you or picked up at a division office. Completed applications must be signed and submitted to the division with the appropriate fees.


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